峡部植骨融合联合节段内钉-钩系统内固定术治疗青年腰椎峡部裂  

Interarticularis bone graft fusion and intrasegmental fixation with pedicle screw-lamina hook system in treatment of young lumbar spondylolysis

作　　者：谭健[1] 李平元[1] 欧军[1] 苏小桃[1] 卢政好[1] 

机构地区：[1]南华大学附属南华医院脊柱外科,湖南衡阳421002

出　　处：《中国现代医学杂志》2014年第19期92-95,共4页China Journal of Modern Medicine

摘　　要：目的探讨应用峡部植骨融合联合节段内钉-钩系统内固定术治疗青年腰椎峡部裂的临床疗效。方法回顾性分析该院2010年7月-2013年3月15例青年腰椎峡部裂患者，均采用峡部植骨融合联合节段内钉-钧系统内固定术治疗；年龄16-32岁，平均23．3岁；采用腰痛视觉模拟评分测评入院时和峡部植骨融合联合节段内钉-钩系统内固定术后（术后3个月、6个月、1年及末次随访），末次随访采用改良MacNab标准评定临床疗效，并了解椎弓峡部融合情况。结果15例患者手术后随访12-42个月，平均20．3个月。所有患者均无神经损伤并发症发生。患者术后不同时期的VAS评分与术前比较差异均有显著性（P〈0．01）。采用改良MacNab标准评价临床结果，优良率为93．33％。末次随访时行CT检查，均无内固定失败和椎弓峡部不融合发生。1例患者术后出现髂骨取骨区疼痛，予以对症治疗后症状缓解。结论峡部植骨融合联合节段内钉-钧系统内固定术治疗青年腰椎峡部裂疗效满意，具有融合率高，并发症少，不影响腰椎活动度的优点。[ Objective ] To investigate the clinical effect of interarticularis bone graft fusion and intrasegmental fixation with pedicle screw-lamina hook system in treatment of young lumbar spondylolysis. [ Methods ] 15 cases of young lumbar spondylolysis patients were retrospectively analyzedin our hospital between July 2010-March 2013 , who underwent interarticularis bone graft fusion and intrasegmental fixation with pedicle screw-lamina hook system; age 16-32 years old, average 23.3 years old; A visual analogue score assessment at admission and postoperative was used,at last followed-up according to the modified MacNab criteria for the assessment of clinical efficacy, parallel CT check interarticularis fusion. [Results] 15 patients were followed up 12 to 54 months after surgery,average 26.3 months.All the patients had no nerve damage complications.Different periods of postoperative compared with the preoperative VAS score had significant difference（P 〈0.01）. According to the modified MacNab criteria, the excellent and good rate was 93.33%. At the last follow-up CT examination, there were no failure of internal fixation and with interarticularis fusion. Pain at donor site of iliac bone occurred in one case, symptomatic treatment after remission. [ Conclusion ] Interarticularis bone graft fusion and intrasegmental fixation with pedicle screw-lamina hook system in treatment of young lumbar spondylolysisexhibitedsatisfied effect with high fusion rate, less complications and didn＇t affect lumbar motion.

关 键 词：腰椎峡部裂 钉-钩系统内固定 植骨 

分 类 号：R681.5[医药卫生—骨科学]